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Biomedical subjects

H Staudenmayer

Publications and source records attributed to H Staudenmayer.

32 records · Page 2Linked to original sources
PubMed1979

Medical outcome in asthmatic patients: effects of airways hyperreactivity and symptom-focused anxiety.

Hypotheses about medical outcome in asthma, indexed by rates of rehospitalization within 6 months after discharge from long-term intensive care, were evaluated. Predictions for rehospitalization were based on the levels of airways hyperreactivity, indexed by inhalation challenges with histamine or methacholine, and levels of anxiety focused upon and concurrent with periods of asthmatic distress, indexed by Panic-Fear symptomatology. Results indicated that, although some prediction could be made on the basis of levels of anxiety and airways hyperreactivity alone, the best predictions resulted from the combined effects of these factors. Almost half of the patients who had highly hyperreactive airways and a tendency to disregard symptoms of breathing difficulty were rehospitalized. By comparison, none of the patients who had less hyperreactive airways and a tendency to be vigilant about their symptoms were rehospitalized. The hypotheses and results are discussed with respect to symptom-focused and general, illness-dependent types of anxiety which have different effects upon medical outcome in chronic asthma. The results have implications for the application of anxiety-reducing forms of intervention in asthma.

Adolescent↗
PubMed1979

Methacholine and histamine inhalation challenges in asthma: relationships to age of onset, length of illness, and pulmonary functions.

Levels of airways hyperreactivity, as indexed by methacholine and histamine thresholds, were determined for hospitalized asthmatic patients using the serial concentration, constant-breath method. Airways hyperreactivity was categorized into low and high based on a split of the sample of subjects tested. These categories were unrelated to pulmonary function measurements obtained throughout hospitalization. Patients having high airways hyperreactivity to histamine or methacholine were admitted for intensive inpatient care at a young age, had an earlier age of onset, and had asthma of longer duration than patients having low airways hyperreactivity. These latter results suggested that relatively greater airways hyperreacticity is more likely to be associated with early onset of the illness.

Adolescent↗
PubMed1979

Parents' subjective evaluation of a self-help education-exercise program for asthmatic children and their parents.

A self-help education-exercise program for asthmatic children and their parents was evaluated in Denver, Colorado. The objective of the program was to instill better self-care practices in the child which are expected to reduce utilization and cost of medical services and reduce the amount of interference in the child's normal activities. The program was designed to educate the family about the nature of asthma and its treatment, the importance of self-responsibility for the child, and the psychosocial aspects which may affect both the child and the parents in a family with an asthmatic child. The program also included specific lessons pertaining to self-care practices including general health exercises on land and in water, relaxation training, and diaphragmatic breathing. The results of subjective evaluations of the parents indicated that the program was successful in achieving its goals to: Reduce the number of severe attacks, reduce medication usage, improve compliance, reduce days of school missed, increase exercise activity, and control wheezing by the steps taught in the course. While the results are suggestive, a further, controlled evaluation of the program is recommended.

Adolescent↗
PubMed1979

Panic-fear in asthma. Symptomatology as an index of signal anxiety and personality as an index of ego resources.

Clinical observations and studies of asthmatic patients have often concluded that therre is a strong relationship between the degree of the patient's anxiety and the medical intractability of his illness. However, psychotherapeutic interventions designed to alleviate patient anxiety have been noticeably inconsistent in achieving meaningful alleviation of the patient's asthma. The present paper addresses this apparent paradox by positing the existence of two types of anxiety: a) asthma-specific anxiety, as indexed by Panic-Fear symptomatology scores of the Asthma Symptom Checklist; and b) characterological and pervasive anxiety, as indexed by Panic-Fear personality scores of the Minnesota Multiphasic Personality Inventory. In this study, long term medical outcome was found to be influenced by the combination of these types of anxiety. Wehn high asthma-specific anxiety coexisted with high characterological anxiety, medical outcome following intensive long term medical treatment was exceptionally poor. In contrast, when high asthma-specific anxiety coexisted with average levels of characterological anxiety, medical outcome was exceptionally good. These results are discussed relative to the theoretical distinctions between signal anxiety and anxiety concomitant with a lack of basic ego resources.

Adolescent↗
PubMed1978

Baseline levels in muscle relaxation training.

Variations in the baseline levels of physiological measures, a familiar problem in psychophysiological research, can affect the results of clinical applications and research in the self-control of bodily processes. In this presentation, the problem is illustrated within the context of skeletal muscle relaxation training using continuous biofeedback (BF) based on surface electromyographic (EMG) activity. In terms of the Law of Initial Values (LIV), higher EMG levels are expected to be associated with greater decreases during training. The combined results of two studies documented an LIV-like effect for pretraining baseline levels with greater EMG decreases after training for subjects with the higher pretraining baselines. Left uncorrected, such baseline differences were shown to lead to discrepant results between two identical studies, and therefore to conflicting conclusions about the effectiveness of these procedures. The available methods suggested to correct for the biasing effect of baseline differences in research are described, with particular emphasis on the analysis of covariance.

Adult↗
PubMed1978

Attitudes toward respiratory illness and hospitalization in asthma. Relationships with personality, symptomatology, and treatment response.

A previous study described the development of the Respiratory Illness Opinion Survey (RIOS) which measures six categories describing attitudes toward respiratory illness and its treatment: Optimism, Negative Staff Regard, Specific Internal Awareness, External Control, Psychological Stigma, and Authoritarian Attitudes. In the present study these attitudes were found: a) to relate more clearly to general personality characteristics than to illness-specific subjective symptomatology; b) to enable types of asthmatic patients to be described on the basis of the patterns of attitude category scores; and c) to provide some information about treatment outcome in asthma as indexed by length of hospitalization during long term, intensive therapy, the need for prescribed oral corticosteroids, and rates of rehospitalization and judged severity following discharge from treatment.

Adaptation, Psychological↗
PubMed1976

Awareness during electromyographic biofeedback: of signal or process?

During relaxation training, awareness of trial-to-trial changes in frontalis-muscle tension levels was assessed with and without auditory electromyographic (EMG) biofeedback. Immediately after each 128-sec training trial, the subject was required to guess whether muscle tension indexed by EMG activity increased ("Up") or decreased ("Down") relative to the immediately preceding trial. The probability of correct guessing, P(c), improved as the absolute difference in EMG increased between trials only when biofeedback was presented. For subjects not receiving biofeedback, P(c) remained low even when the absolute difference between trials was large. Subjects in each condition employed a strategy to guess "Down" more often consistent with the expectation that they were being trained to relax. The "Down" set strategy was shown to be separable from the informational basis of P(c) provided by biofeedback. This procedure can be employed to evaluate central assumptions of biofeedback relating to posttraining awareness of changes in muscle tension and the relationship between awareness and control of muscle tension.

Acoustic Stimulation↗
PubMedDate not supplied

Obervations on subjective symptomatology, coping behavior, and medical decisions is asthma.

The Asthma Symptom Checklist (ASC), describing the subjective symptoms reported to occur during asthmatic attacks, has been developed previously. In the present study, the ASC key cluster solution was replicated and refined within a sample of 374 asthmatic inpatients. All of the original symptom categories were reporduced, including two mood categories, Panic-Fear and Irritability, a Fatigue category, and two somatic categories. Hyperventilation-Hypocapnia and Airway Obstruction. Two refinements were notable: (1) The Airway Obstruction category was empirically divided into two conceptually clear components, Dyspnea anc Congestion, and (2) three secondary mood categories, Worry, Loneliness, and Anger, were identified, which describe a continuum of mood between the polar extremes of panic and irritability. Of the symptom categories, only Panic-Fear was related to the intensity of the discharge drug regimens recommended 2 to 6 mouths after ASC administration. Panic-Fear scores were independent of pulmonary function measurements. A combined index based on pulmonary functions and panic-fear yielded the best prediction of discharge steroid regiments. Finally, those physicians rated highest in "sensitivity" to their patients by their supervisors prescribed less steroids overall, but most frequently prescribed discharge steriod regimens in relation to their patients' Panic-Fear scores. In contrast, physicians rated lower on sensitivity prescribed higher steroid regimens overall, but based these drug recommendations more cleary on objective pulmonary functioning, and not in relation to their patients' Panic-Fear scores. The results strongly suggest that the ASC Panic-Fear scale is associated with coping behaviors that importantly affect the patient's overall clinical picture by increasing the apparent severity of the asthma, thereby leading to intensified treatment. The findings stress the need to evaluate independently the objective medical condition and subjective symptomatology with its related coping behavior, in order to direct appropriate modes of therapy to each.

Adaptation, Psychological↗
PubMedDate not supplied

Psychological treatment of psychogenic idiopathic environmental intolerance.

This chapter focuses on the psychotherapy of individuals who suffer distress from functional somatic syndromes; specifically, idiopathic environmental intolerance (IEI). While patients believe environmental intolerances cause their distress, its origin is treated as psychological, mediated through psychophysiological systems and mechanisms associated with the stress response. Factors considered include stress and trauma premorbid to the alleged onset of IEI; somatization and its expression through affective, anxiety, and somatoform disorders; personality disorders and associated psychological defenses; motivation for the sick role; and iatrogenic suggestion and reinforcement of unsubstantiated toxicogenic theories and treatments. Psychotherapies include behavioral desensitization, cognitive-behavioral therapy, cognitive therapy, and psychotropic medications. The greatest challenge in treatment is to overcome the patient's disabling belief in a toxicogenic explanation for his or her symptoms.

Behavior Therapy↗